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[Correspondence] Titrated doses are optimal for opioids in pain trials – Authors’ reply

Bruno Riou and Frédéric Aubrun accurately summarised the key advantages of intramuscular non-steroidal anti-inflammatory drugs (NSAIDs) over intravenous opioids, as shown by the results of our randomised clinical trial.1 A standardised single dose of NSAID provides a ceiling effect, does not have a cumulative dose effect, and is associated with minimal adverse effects. By contrast, opioids are associated with enormous variability in their effect between individuals, demanding a personalised tailored approach to analgesia.